Thursday, August 25, 2011

Okay, clearly I've been on the floors for too long when I find myself jealous of residents working directly in the path of Hurricane Irene. Hospital evacuations? Sign me up. Getting to start over with a clean slate-- goodbye, malingerers! goodbye, people waiting for nursing home placement! goodbye, angry bipolar lady who threw her applesauce at me!-- would be like a dream come true.

I don't dream about normal things anymore. I wake up in a panic, because I've been dreaming about forgetting to put in an order, or having to yell at my interns, or watching a patient urinate on the floor. Three times in the past two weeks, I've had a dream that I am watching a patient urinate. I wake up and desperately have to use the bathroom.

I go back and forth between feeling like I'm a babysitter and feeling like I'm in over my head. One day it's three lumbar punctures and a central line, and, oh, wait, it's 7:00 and someone needs a paracentesis. The next day it's seven patients we can't find placement for, so they're just sticking around, taking up a bed, for no good reason. There are no good days on the floor. Because as soon as you think you're having a good day, you get paged about your brand new patient, who just threw up blood in the ER and you should really get down there and take his history before he loses consciousness.

"What would happen if someone stole drugs?" one of my interns asks me.

"Why are you asking me this?"

"Oh, I'm just curious."

Note to interns: not a good question to ask your resident.

Other bad questions for interns to ask their residents:

"What happens if you forget to put in an order?"
"Did you see where one of my patients went?"
"What number are you supposed to dial when a patient isn't breathing?"
"Do the pagers work if you take the batteries out?"
"I don't have to save my patient note on the system before signing out, do I?"
"Are drug interactions really a thing?"
"It's okay to skip a dose of chemotherapy, right?"
"What happens if someone who's supposed to be fasting eats lunch?"
"Who do you call for an MRI after business hours?"
"Can I just assume the patient wanted to be DNR?"
"Just one needle stick won't infect me with anything, right?"
"Remind me how to do CPR, okay?"
"Will it affect my evaluation if I strangle a patient to death?"

"If I was going to call in sick so I could fly to a wedding this weekend, but now I can't go because the wedding's in North Carolina and my flight is canceled, can I call in sick anyway and not show up?"